Background Innovative customized computer‐aided design/computer‐assisted manufacture (CAD‐CAM) titanium meshes have been proposed for guided alveolar bone regeneration. Histological confirmation on the quality of the regenerated bone is needed. Purpose of the study is to assess the integration capabilities of these innovative meshes and to evaluate the histological features of the regenerated alveolar bone. Materials and methods Twenty partially edentulous patients, with severe posterior mandibular atrophy, underwent a guided bone regeneration technique by means of customized CAD‐CAM titanium mesh in association with a mixture of autologous bone in chips and deproteinized bovine bone (1:1). At 9 months of healing, titanium meshes and bone samples were collected and histomorphometrically analyzed. Results In all patients, implants were placed according to the original plan. At histologic analysis, mesh appeared well osseointegrated, except that in sites where membrane exposure occurred. In all sites, newly formed tissue resulted highly mineralized, well‐organized, and formed by 35.88% of new lamellar bone, 16.42% of woven bone, 10.88% of osteoid matrix, 14.10% of grafted remnants, and 22.72% of medullary spaces. Blood vessels were the 4% of the tissue. Conclusions Data from this study support the use of customized CAD/CAM titanium mesh for regeneration of vital, well‐structured, and vascularized alveolar bone.

COVID-19, a recently emerged disease caused by SARS-CoV-2 infection, can present with different degrees of severity and a large variety of signs and symptoms. The oral manifestations of COVID-19 often involve the tongue, with loss of taste being one of the most common symptoms of the disease. This study aimed to detect SARS-CoV-2 RNA and assess possible morphological and immunopathological alterations in the lingual tissue of patients who died with a history of SARS-CoV-2 infection. Sixteen cadavers from 8 SARS-CoV-2 positive (COVID-19+) and 8 negative (COVID-19−) subjects provided 16 tongues, that were biopsied. Samples underwent molecular analysis through Real-Time RT-PCR for the detection of SARS-CoV-2 RNA. Lingual papillae were harvested and processed for histological analysis and for immunohistochemical evaluation for ACE2, IFN-γ and factor VIII. Real-Time RT-PCR revealed the presence of SARS-CoV-2 RNA in filiform, foliate, and circumvallate papillae in 6 out of 8 COVID-19+ subjects while all COVID-19− samples resulted negative. Histology showed a severe inflammation of COVID-19+ papillae with destruction of the taste buds. ACE2 and IFN-γ resulted downregulated in COVID-19+ and no differences were evidenced for factor VIII between the two groups. The virus was detectable in most COVID-19+ tongues. An inflammatory damage to the lingual papillae, putatively mediated by ACE2 and IFN-γ in tongues from COVID-19+ cadavers, was observed. Further investigations are needed to confirm these findings and deepen the association between taste disorders and inflammation in SARS-CoV-2 infection.

Background and Objectives: Wound healing is a dynamic process that can be compromised in patients with chronic and metabolic conditions or unhealthy lifestyles. Numerous medical substances designed for topical use, charged with compounds that promote the healing process, have been developed to improve wound healing, especially in compromised subjects. The present study aimed to extend our understanding of the in vivo effects of a hyaluronic acid gel charged with amino acids (HAplus gel, Aminogam gel® Errekappa Euroterapici spa, Milan, Italy) and study the in vitro effects of the same gel charged with additional substances in an attempt to optimize its formulation. Materials and Methods: In a randomized controlled split-mouth clinical and histological trial, HAplus gel was tested on the gingival tissue of the lower third molar post-extraction socket. The gingiva was collected at the time of extraction (T0) and ten days after the extraction (T1) to be histologically analyzed. During the second stage of the study, culture media with HAplus gel and vitamin C and E at different concentrations (TEST) were tested on human gingival fibroblasts and compared to the HAplus-enriched medium (HA-Control). Results: Histological and immunohistochemical analysis of collected gingiva showed higher microvascular density and collagen fibers organized in closely packed and well-oriented bundles in sites treated with HAplus gel. In the in vitro study, all TEST groups showed an increased viability from 24 h to 48 h. After 24 h, the viability percentage in all experimental groups was below 100% of the HA-Control, demonstrating a mild toxicity. After 48 h from seeding, the TEST groups’ viability grew significantly compared to HA-Control. Conclusions: These encouraging preliminary results suggest that the use of HAplus gel enriched with vitamins C and E may be beneficial in patients with conditions that impair soft tissue healing.

The lips and their relationship with the positions of anterior teeth considerably affect a person's smile and facial esthetics in general. In this study, the changes in lip dimensions and position in three-dimensions during the period between adolescence (12 boys and 12 girls aged 13 -15 years) and young adulthood (10 men and 11 women aged 20-24 years) in normal, untreated subjects were measured, along with the age-related modifications in the clinical crown dimensions of maxillary and mandibular anterior teeth. The three-dimensional coordinates of selected soft-tissue facial and dental landmarks were directly digitized on the subjects using a non-invasive electromagnetic instrument. From the landmark coordinates, the total vermilion and upper lip heights; mouth width; intercanine and interincisor distances; clinical crown heights and widths of anterior teeth; interlabial, nasolabial, mentolabial, dentolabial and inciso-occlusal angles were calculated. Mean values for each sex and age group were computed and compared using two-way factorial analysis of variance. Results have shown that soft-tissue growth in the lip area has not subdued in adolescent males, while it has slowed in females; moreover, there was some degree of eruption of the maxillary anterior teeth in adolescent males, thus modifying dento-labial relationships. On average, males have a tendency toward a wider, thinner, and flatter lip area with growth. The various growth phenomena still to take place in adolescent males should be taken into consideration when commencing treatment: enucleation of four premolars may for example enhance a natural tendency toward a flatter lip area.

Objective To supply quantitative information about the facial soft tissues of adult operated patients with cleft lip and palate (CLP). Design, Setting, and Patients The three-dimensional coordinates of soft tissue facial landmarks were obtained using an electromagnetic digitizer in 18 Caucasian patients with CLP (11 males and 7 females aged 19 to 27 years) and 162 healthy controls (73 females and 89 males aged 18 to 30 years). From the landmarks, 15 facial dimensions and two angles were calculated. Data were compared with those collected in healthy individuals by computing z-scores. Two summary anthropometric measurements for quantifying craniofacial variations were assessed in both the patients and reference subjects: the mean z-score (an index of overall facial size), and its SD, called the craniofacial variability index (an index of facial harmony). Results In treated patients with CLP, facial size was somewhat smaller than in normal individuals, but in all occasions the mean z-score fell inside the normal interval (mean ± 2 SD). Almost all patients had a craniofacial variability index larger than the normal interval, indicating a global disharmonious appearance. Overall, in patients pronasale, subnasale, and pogonion were more posterior, the nose was shorter and larger, the face was narrower, and the soft tissue profile and upper lip were flatter than in the reference population. Conclusions The facial soft tissue structures of adult operated patients with CLP differed from those of normal controls of the same age, sex, and ethnic group. In this patient group, surgical corrections of CLP failed to provide a completely harmonious appearance, even if the deviations from the reference were limited. Further analyses of larger groups of patients are needed.